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Jiménez-Pulido I, Albert-Marí MA, Conde-Estévez D, San José-Ruiz B, Gil-Lemus MÁ, Cercós-LLetí AC, Esteban-Mensua MJ, Díaz-Carrasco MS. GEDEFO-SEFH management of antineoplastic extravasations survey results. J Oncol Pharm Pract 2024; 30:67-77. [PMID: 37032471 DOI: 10.1177/10781552231167873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
INTRODUCTION Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal management scheme. The objective of this study is to describe the clinical practice in the extravasation management of antineoplastic agents in Spanish centers. METHODS An online survey was distributed to oncology pharmacists using the email distribution list of the Spanish Society of Hospital Pharmacists. Respondents were surveyed on the standard operational protocol (SOP) of extravasation, tissue damage risk classification, and specific measures of extravasation management. RESULTS A total of 68 surveys were completed. A specific extravasation SOP was available in 82.4% centers. The pharmacist participates in the authorship (100%) and actively collaborates in extravasation management (76.5%). A tissue damage risk classification based on the three categories was mostly adopted (48.2%) and 73.2% applied specific criteria based on concentration and/or extravasated volume. Extravasation management was mainly performed with the application of physical measures and/or antidotes (91.2%). High variability in the choices of pharmacological and/or physical measures recommended is outstanding. CONCLUSION The results of this study highlight the involvement of Spanish pharmacists in extravasation management, the application of physical measures and/or pharmacological measures as the method of choice in extravasation management, as well as the existing discrepancies in tissue damage risk classification and management recommendations.
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Affiliation(s)
| | | | - David Conde-Estévez
- Servicio de Farmacia, Consorci Parc de Salut MAR de Barcelona, Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Catalunya, Spain
| | - Begoña San José-Ruiz
- Servicio de Farmacia, Hospital Universitario Cruces, Barakaldo, País Vasco, Spain
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González-Colominas E, López-Mula C, Martínez-Casanova J, Luque S, Conde-Estévez D, Monge-Escartín I, Ferrández O. Primary care electronic medication record discrepancies in patients starting treatment at a hospital-based ambulatory care pharmacy and impact on prevalence of potential drug-drug interactions. Eur J Hosp Pharm 2023; 30:333-339. [PMID: 35086803 PMCID: PMC10647874 DOI: 10.1136/ejhpharm-2021-002963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Our objective was to evaluate the prevalence of discrepancies between primary care electronic medication records (EMR) and patient reported medication (PRM) in ambulatory patients starting a hospital dispensing treatment (HDT) at a hospital-based ambulatory care pharmacy (HACPh). Our secondary aims were to analyse factors associated with the presence of discrepancies and their impact on the prevalence of potential drug-drug interactions (DDIs) with the HDT. METHODS Retrospective study including 230 patients starting a HDT at the HACPh. Pharmacists interviewed patients and PRM was compared with EMR. Discrepancies were classified as omissions (medication in the PRM not present in the EMR) and commissions (medication active in the EMR that the patients were not taking). Potential DDIs with the HDT were screened, and univariate and multivariate analyses were performed to detect factors associated with the presence of discrepancies. RESULTS We identified 221 discrepancies in 116 (50.4%) patients. Being visited by three or more medical specialties (OR 1.93, 95% CI 1.11 to 3.37) and attending private healthcare (OR 4.36, 95% CI 1.14 to 16.72) in the 12 months before the study inclusion were the factors independently associated with the presence of discrepancies. Among patients with commissions (n=91), 15.4% had a potential DDI between the HDT and one medication from the EMR that they were not taking at that moment. Among patients with omissions (n=45), 11.1% had a potential DDI between the HDT and a medication in the PRM not present in the EMR. CONCLUSIONS About 40% of patients had one or more medications in the EMR which they were not taking and one fifth used medications that were not listed in the EMR. EMR should not be used as the only source of information when screening for DDIs, especially in patients followed by different medical specialties or combining private and public healthcare.
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Affiliation(s)
- Elena González-Colominas
- Pharmacy, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
- Pharmacology, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | | | | | - Sonia Luque
- Pharmacy, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
- IMIM, Barcelona, Catalunya, Spain
| | - David Conde-Estévez
- Pharmacy, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
- Pharmacology, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | | | - Olivia Ferrández
- Pharmacy, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
- Pharmacology, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Echeverria-Esnal D, Sorli L, Navarrete-Rouco ME, Prim N, Barcelo-Vidal J, Conde-Estévez D, Montero MM, Martin-Ontiyuelo C, Horcajada JP, Grau S. Ampicillin-resistant and vancomycin-susceptible Enterococcus faecium bacteremia: a clinical narrative review. Expert Rev Anti Infect Ther 2023. [PMID: 37294450 DOI: 10.1080/14787210.2023.2223977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Enterococcus faecium is a commensal microorganism that can cause infections such as bacteremia. Incidence of ampicillin-resistant and vancomycin-susceptible E. faecium (EfARSV) bacteremia is on the rise, and the mortality rate is high. Despite much data, the most appropriate treatment remains a question. AREAS COVERED This article mostly reviews the relevant aspects of EfARSV bacteremia: microbiology, gastrointestinal tract colonization and invasion, antibiotic resistance, epidemiology, risk factors, mortality, and treatment, including pharmacologic components of employed agents and related clinical evidence. A literature search was conducted on PubMed on 31 July 2022, which was updated on 15 November 2022. EXPERT OPINION EfARSV bacteremia presents high mortality. However, it is uncertain whether mortality is attributable to or a marker of severity/comorbidities. Considering its antibiotic resistance pattern, EfARSV is considered a difficult-to-treat microorganism. Glycopeptides have been used to treat EfARSV, with linezolid and daptomycin serving as potential alternative agents. Yet, the use of daptomycin is controversial due to a higher risk of treatment failures. Clinical evidence on this issue is scarce, unfortunately, and subject to many limitations. Despite increased incidence and mortality, EfARSV bacteremia presents multiple aspects to be addressed in well-conducted studies.
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Affiliation(s)
- Daniel Echeverria-Esnal
- Department of Pharmacy, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Luisa Sorli
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Department of Infectious Diseases, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Spain
| | | | - Nuria Prim
- Laboratori de Referència de, Department of Microbiology, Barcelona, Catalunya, Spain
| | - Jaime Barcelo-Vidal
- Department of Pharmacy, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
| | - David Conde-Estévez
- Department of Pharmacy, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - María Milagro Montero
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Department of Infectious Diseases, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid, Spain
| | - Clara Martin-Ontiyuelo
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid, Spain
- Department of Pulmonary Medicine, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Juan Pablo Horcajada
- Department of Pharmacy, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Infectious Diseases, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Santiago Grau
- Department of Pharmacy, Hospital Del Mar, Parc de Salut Mar, Barcelona, Spain
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC CB21/13/00002 and CB21/13/00099), Institute of Health Carlos III, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
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Conde-Estévez D, Henríquez I, Muñoz-Rodríguez J, Rodriguez-Vida A. Treatment of non-metastatic castration-resistant prostate cancer: facing age-related comorbidities and drug–drug interactions. Expert Opin Drug Metab Toxicol 2022; 18:601-613. [DOI: 10.1080/17425255.2022.2122812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- David Conde-Estévez
- Department of Pharmacy, Hospital Del Mar, Barcelona, Spain
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Iván Henríquez
- Department of Radiation Oncology, Hospital Universitario Sant Joan, Reus, Spain
| | | | - Alejo Rodriguez-Vida
- Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medical Oncology, Hospital Del Mar, CIBERONC, Barcelona, Spain
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Albert-Marí A, Jiménez-Pulido I, José-Ruiz BS, Conde-Estévez D, Gil-Lemus MÁ, Cercós-Lletí AC, Esteban-Mensua MJ, Díaz-Carrasco MS. Antineoplastic extravasation management: Consensus of the Spanish Oncology Pharmacy Group (GEDEFO). J Oncol Pharm Pract 2022:10781552221091914. [PMID: 35469494 DOI: 10.1177/10781552221091914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Asunción Albert-Marí
- Servicio de Farmacia, 16273Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | | | - Begoña San José-Ruiz
- Servicio de Farmacia, 16494Hospital Universitario Cruces, Barakaldo, Pais Vasco, Spain
| | - David Conde-Estévez
- Servicio de Farmacia Hospital del Mar, IMIM (Institut Hospital del Mar d'Investigacions Mediques), Barcelona, Spain
| | - Mª Ángeles Gil-Lemus
- Servicio de Farmacia, 16494Hospital Universitario Cruces, Barakaldo, Pais Vasco, Spain
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Conde-Estévez D, Barrantes-González M, Cotrina Soliz MR, Grau S. Successful management of remdesivir extravasation. Rev Esp Quimioter 2022; 35:229-230. [PMID: 35118854 PMCID: PMC8972699 DOI: 10.37201/req/147.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Affiliation(s)
- D Conde-Estévez
- David Conde Estévez, Department of Pharmacy, Hospital Universitari del Mar. Passeig Marítim 25-29, E-08003, Barcelona, Spain.
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Echeverria-Esnal D, Martín-Ontiyuelo C, Navarrete-Rouco ME, Barcelo-Vidal J, Conde-Estévez D, Carballo N, De-Antonio Cuscó M, Ferrández O, Horcajada JP, Grau S. Pharmacological management of antifungal agents in pulmonary aspergillosis: an updated review. Expert Rev Anti Infect Ther 2021; 20:179-197. [PMID: 34328373 DOI: 10.1080/14787210.2021.1962292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Aspergillus may cause different types of lung infections: invasive, chronic pulmonary or allergic bronchopulmonary aspergillosis. Pharmacological management with antifungals poses as a challenge. Patients diagnosed with pulmonary aspergillosis are complex, as well as the problems associated with antifungal agents. AREAS COVERED This article reviews the pharmacology of antifungal agents in development and currently used to treat pulmonary aspergillosis, including the mechanisms of action, pharmacokinetics, pharmacodynamics, dosing, therapeutic drug monitoring and safety. Recommendations to manage situations that arise in daily clinical practice are provided. A literature search of PubMed was conducted on November 15th, 2020 and updated on March 30th, 2021. EXPERT OPINION Recent and relevant developments in the treatment of pulmonary aspergillosis have taken place. Novel antifungals with new mechanisms of action that extend antifungal spectrum and improve pharmacokinetic-related aspects, drug-drug interactions and safety are under current study. For those antifungals already marketed, new data related to pharmacokinetics, pharmacodynamics, dose adjustments in special situations, therapeutic drug monitoring and safety are available. To maximize efficacy and reduce the risk of associated toxicities, it is essential to choose the most appropriate antifungal; optimize its dose, interval, route of administration and length of treatment; and prevent side effects.
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Affiliation(s)
- Daniel Echeverria-Esnal
- Pharmacy Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain.,Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | | | | | | | - David Conde-Estévez
- Pharmacy Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain.,Department Of Pharmacology, Universitat Autònoma De Barcelona, Barcelona, Spain
| | - Nuria Carballo
- Pharmacy Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain
| | | | - Olivia Ferrández
- Pharmacy Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain
| | - Juan Pablo Horcajada
- Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.,Department Of Pharmacology, Universitat Autònoma De Barcelona, Barcelona, Spain.,Infectious Diseases Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain
| | - Santiago Grau
- Pharmacy Department, Hospital Del Mar, Parc De Salut Mar, Barcelona, Spain.,Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital Del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.,Department Of Pharmacology, Universitat Autònoma De Barcelona, Barcelona, Spain
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8
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Albert-Marí A, Gil-Lemus MªÁ, Conde-Estévez D, San José-Ruiz B, Jiménez-Pulido I, Esteban-Mensua MªJ, Cercós-Lletí AC, Díaz-Carrasco MªS. Classification of antineoplastic drug-induced tissue damage: a Consensus of the Spanish Oncology Pharmacy Group. Farm Hosp 2021; 45:198-203. [PMID: 34218766 DOI: 10.7399/fh.11625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To reach at an expert consensus, using the Delphi method, for classifying the tissue-damaging potential of antineoplastic drugs, in order to facilitate the decision-making process in the event of extravasations. METHOD The panel of expert evaluators was made up of seven pharmacists belonging to the working group on extravasations. Other member served as coordinator. The likelihood of tissue damage was reviewed on the basis of eight reference documents. Four categories of drugs were established: vesicant (V); high risk irritant (HRI); low risk irritant (LRI) and non-irritant (NI). Two rounds of surveys were performed. The drugs with an agreement of less than 70% after the two rounds were discussed non-anonymously by the group. For each of the rounds the following was analysed: median of the degree of consensus and the interquartile range (IQR25-75), degree of agreement by tissue damage category, and percentage of antineoplastics reaching a degree of consensus of over 85% and of 100%. Drugs whose classification differed in the various reference documents were assessed separately. SPSS v23.0 statistical software was used. RESULTS Seventy-one antineoplastics were evaluated. In the first round, the median for degree of consensus was 100.0% (IQR25-75: 71.4- 100.0%). In the second round, the median was 100.0% (IQR25-75: 85.7- 100.0%). The percentage of antineoplastics with a consensus of 85.7% or above increased from 66.7% to 85.9% in the second round. For the 30 antineoplastics whose values differed in the reference documents, the degree of agreement increased from 71.4% (IQR25-75: 57.1-87.7%) to 100.0% (IQR25-75: 85.7-100.0%) in the second round. The percentage of antineoplastics with a consensus of 85.7% or above increased from 40.0% to 76.7%. Four antineoplastics had a degree of agreement of less than 70.0%. The final classification of drugs per category, was: 17 vesicants; 15 HRI; 13 LRI; and 26 NI. The final degree of consensus was 85.7% or above for 90.1% of antineoplastics, and 100.0% for 74.6% of the same. CONCLUSIONS In this area of scarce evidence and high variability, the Delphi method allows for consensus in classifying tissue damage risk, thus making it easier to reach clinical decisions. In approximately 90% of the antineoplastics, the degree of consensus reached by the expert panel was 85% or above. In 74% of the antineoplastics, it was 100%. This provides solid ground for management decisions.
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Affiliation(s)
- Asunción Albert-Marí
- Department of Pharmacy, Hospital Universitario y Politécnico La Fe, Valencia. Spain..
| | | | - David Conde-Estévez
- Department of Pharmacy, Hospital del Mar, Barcelona. IMIM (Institut Hospital del Mar d'Investigacions Médiques), Barcelona. Spain..
| | - Begoña San José-Ruiz
- Department of Pharmacy, Hospital Universitario Cruces, Barakaldo (Vizcaya). Spain..
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Conde-Estévez D, Monge-Escartín I, Ríos-Hoyo A, Monzonis X, Echeverría-Esnal D, Moliner L, Duran-Jordà X, Taus Á, Arriola E. Prognostic factors and effect on survival of immune-related adverse events in patients with non-small-cell lung cancer treated with immune checkpoint blockage. J Chemother 2020; 33:32-39. [DOI: 10.1080/1120009x.2020.1849488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- David Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autónoma de Barcelona, Barcelona, Spain
| | | | - Alejandro Ríos-Hoyo
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | - Xavier Monzonis
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | | | - Laura Moliner
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
| | - Xavier Duran-Jordà
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
- Methodology & Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Álvaro Taus
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
| | - Edurne Arriola
- Department of Medical Oncology, Hospital Universitari del Mar-CIBERONC, Barcelona, Spain
- IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain
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10
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Fernández-Sala X, Barceló-Vidal J, Tusquets I, Conde-Estévez D. Effectiveness and safety of a novel dexamethasone mouthwash formulation in managing stomatitis in cancer patients. Farm Hosp 2020; 45:41-44. [PMID: 33443477 DOI: 10.7399/fh.11460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To present a new dexamethasone mouthwash formulation and analyze its effectiveness and safety among patients receiving stomatitis-producing antineoplastic agents. METHOD Prospective observational study conducted in a university hospital between March 2017 and November 2019. Consecutive patients starting everolimus were enrolled. Patients were instructed to rinse dexamethasone mouthwash formulation twice daily until discontinuation of everolimus. A second cohort of patients with existing stomatitis induced by high probability of producing stomatitis chemotherapy therapies was also recruited to assess treatment effectiveness. Effectiveness and safety of dexamethasone mouthwash formulation was assessed. RESULTS Dexamethasone mouthwash formulation was prescribed in nine patients as prophylaxis. Six patients were diagnosed with breast cancer, two with neuroendocrine tumor and one with renal cell carcinoma. Four patients developed mild stomatitis (grade 1-2) and three patients discontinued everolimus due to other treatment-related adverse events. In addition, dexamethasone mouthwash formulation was prescribed as treatment in five patients with existing stomatitis. All patients achieved a significant reduction in the severity of stomatitis after starting the dexamethasone mouthwash formulation. In both cohorts, dexamethasone mouthwash formulation was well tolerated and neither dose reduction nor discontinuation related to stomatitis was required. CONCLUSIONS Dexamethasone mouthwash formulation could be considered as a suitable alternative for stomatitis management.
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Affiliation(s)
| | | | - Ignasi Tusquets
- Department of Medical Oncology, Hospital Universitari del Mar, Barcelona. Spain. Hospital del Mar Research Insitute (IMIM), Barcelona. Spain. Universitat Autónoma de Barcelona, Barcelona. Spain..
| | - David Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar, Barcelona. Spain. Hospital del Mar Research Insitute (IMIM), Barcelona. Spain. Universitat Autónoma de Barcelona, Barcelona. Spain..
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Fernandez Sala X, Casadevall Aguilar D, Masfarré L, Conde-Estévez D. 1776P Analysis of potencial drug interactions in oncologic patients diagnosed with COVID-19. Ann Oncol 2020. [PMCID: PMC7506444 DOI: 10.1016/j.annonc.2020.08.1840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
INTRODUCTION Extravasation is a rare complication from intravenous chemotherapy administration. Literature about monoclonal antibody (MoAb) extravasations is scarce and also conflicting in how they are classified. CASE REPORT We reported two different cases of MoAb extravasations with cetuximab and nivolumab outcome respectively. The administration site appeared inflamed and patients did not report disturbances.Management and outcome: Both extravasations did not require specific treatment. General unspecific measures suffice to properly manage these extravasations and no sequels were observed after long follow-up. Both patients received all further courses of MoAb without any adverse events. DISCUSSION To our knowledge, we reported the first case-report of nivolumab extravasation in the literature. In addition, the cetuximab extravasation management and outcome was in accordance with previously published reports. Both MoAb may be considered as non-aggressive or neutral. We reviewed published information about MoAb extravasations. In conclusion, not all MoAb should be classified in the same category when extravasated and special precautions are warranted with conjugated MoAb and bevacizumab.
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Affiliation(s)
| | - David Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar, Barcelona, Spain.,Cancer Research Program, IMIM (Instituto de Investigación Hospital del Mar), Barcelona, Spain.,Pharmacology Department, Universitat Autónoma de Barcelona, Barcelona, Spain
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Domínguez-Alonso JA, Conde-Estévez D, Bosch D, Pi-Figueras M, Tusquets I. Breast cancer, placing drug interactions in the spotlight: is polypharmacy the cause of everything? Clin Transl Oncol 2020; 23:65-73. [PMID: 32449126 DOI: 10.1007/s12094-020-02386-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/10/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Breast cancer is the most prevalent and lethal cancer among women. Forty-one percent of cases occur in people ≥ 70 years, hindering their treatment given its comorbidities and polypharmacy (PP). Potential drug-drug interactions (PDDI) were analyzed in elderly breast cancer patients between daily and oncospecific treatments and their associations with Age, BMI, Mini Nutritional Assessment (MNA), Frailty categorization, PP, and adverse effects. PATIENTS/METHODS A cohort of 77 patients ≥ 70 years with breast cancer who underwent a Comprehensive Geriatric Assessment (CGA) were included. Clinical characteristics were collected using medical records. PDDI between treatments were analyzed using two databases. Data were assessed using linear regression, Chi-square, Mann-Whitney U, and Kruskal-Wallis tests. Finally, a multivariate logistic regression model was built and tested to predict adverse effects. RESULTS From 719 PDDI, 530 (74%) were moderate (r2 = 0.72) and the median number of drugs during oncospecific treatment (r2 = 0.73) was 9 (range 3-26). Overall, 59 patients (77%) had adverse effects associated with Frailty categorization and MNA (p < 0.05). The distribution of major, moderate, minor, and total PDDI was associated with PP at CGA and during oncospecific treatment (p < 0.05). Moreover, it was verified that Frailty categorization protects from adverse effects given the intervention made at CGA. CONCLUSIONS CGA should be applied in oncologic elderly patients to assess clinical outcomes and categorize them according to their frailty but also to analyze PDDI. Furthermore, we encourage the use of the model in clinical practice for predicting the occurrence of adverse effects, improving therapeutic conciliation.
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Affiliation(s)
| | | | - David Bosch
- Departament de Dinàmica de la Terra i de l'Oceà, Facultat de Ciències de la Terra, Universitat de Barcelona, Barcelona, Spain
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14
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Domínguez-Alonso JA, Conde-Estévez D, Pi-Figueras M, Servitja S, Digón A, Albanell J, Tusquets I. Breast cancer, placing drug interactions in the spotlight: Is polypharmacy the cause of everything? J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24027 Background: Breast cancer is the most prevalent and lethal cancer among women. Forty one percent of cases occur in people ≥ 65 years. Decision on cancer treatment is particularly challenging among this group of age given its comorbidities and polypharmacy (PP). The main objectives are the analysis of potential drug-drug interactions (PDDI) in elderly breast cancer patients between daily medications and oncospecific therapy and their probable associations with age, BMI, Mini Nutritional Assessment (MNA), frailty and PP and the adverse effects during oncospecific treatment. Methods: A cohort of 77 patients ≥ 70 years with breast cancer underwent a Comprehensive Geriatric Assessment (CGA) by a Geriatrist at a university hospital. Baseline characteristics of the patients, demographical data, cancer stage, and oncospecific and daily treatments, as well as the complications and derived adverse effects were retrospectively collected using electronic medical records. Moreover, frailty categorization, daily medication number, comorbidities, Lawton and Barthel Index, malnutrition, MNA, BMI were prospectively collected using CGA report. PDDI between daily and oncospecific treatments were analyzed. Results: The median age of patients was 85 years (range 72-95). The median number of daily medications at CGA was 6 drugs (range 0-22) and most of the patients had PP at CGA and during oncospecific treatment (73% and 91%, respectively). Out of 719 PDDI, 530 (74%) were moderate ( r2= 0.72) and the median number of drugs during oncospecific treatment ( r2= 0.73) was 9 (range 3-26). Overall, by using Kruskal Wallis, 59 patients (77%) had any adverse effects statistically associated with frailty categorization and MNA ( p < 0.05). Furthermore, there was a tendency with oncospecific treatment, BMI and age ( p = 0.098, 0.089 and 0.062, respectively). The distribution of major, moderate and minor as well as total PDDI was statistically associated with PP at CGA and during oncospecific treatment ( p < 0.05). Conclusions: CGA should be applied in oncology elderly patients not only to assess clinical outcomes and categorize them in each frailty group but also to analyze PDDI by using specific web databases, thereby improving PP, PDDI and economic costs.
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Affiliation(s)
| | | | | | - Sonia Servitja
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
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Echeverria-Esnal D, Sorli L, Prim N, Conde-Estévez D, Mateu-De Antonio J, Martin-Ontiyuelo C, Horcajada JP, Grau S. Linezolid vs glycopeptides in the treatment of glycopeptide-susceptible Enterococcus faecium bacteraemia: A propensity score matched comparative study. Int J Antimicrob Agents 2019; 54:572-578. [PMID: 31476435 DOI: 10.1016/j.ijantimicag.2019.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 08/19/2019] [Accepted: 08/24/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The incidence of ampicillin-resistant Enterococcus faecium bacteraemia is increasing. Vancomycin remains the first-line treatment in areas with a high prevalence of glycopeptide-susceptible isolates, but data comparing its clinical outcomes with other treatments are lacking. The objective of this study was to compare the effectiveness and safety of linezolid and glycopeptides for the treatment of glycopeptide-susceptible E. faecium bloodstream infection (GSEF-BSI). METHODS This retrospective observational cohort study was conducted from January 2006 to May 2018 at the Hospital del Mar, Barcelona, Spain, and compared the clinical outcomes and safety of linezolid and glycopeptides in adult patients with GSEF-BSI. The main outcomes included clinical cure at the end of therapy, 30-day mortality, microbiological eradication and attributable length of stay (LOS). Propensity score matching was performed to reduce potential confounders among groups. RESULTS In total, 105 patients with GSEF-BSI were included (linezolid, n=38; glycopeptides, n=67). After propensity score matched analysis, 56 (53.3%) patients, 28 in each cohort, entered the final analysis. No differences were observed in any of the main clinical outcomes among patients treated with linezolid or glycopeptides: clinical cure [16/28 (57.1%) vs 13/28 (46.4%), P=0.593], 30-day mortality [8/28 (28.6%) vs 12/28 (42.9%), P=0.403], microbiological eradication [22/28 (78.6%) vs 20/28 (71.4%), P=0.758] and median attributable LOS (18.0 vs 17.0 days, P=0.924). Adverse events were similar in both groups. CONCLUSIONS Linezolid and glycopeptides showed similar clinical effectiveness and safety in the treatment of GSEF-BSI. Linezolid could be an alternative to glycopeptides in the treatment of GSEF-BSI.
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Affiliation(s)
- D Echeverria-Esnal
- Service of Pharmacy, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Sorli
- Service of Infectious Diseases, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Prim
- Service of Microbiology, Laboratori de Referència de Catalunya, Barcelona, Spain
| | - D Conde-Estévez
- Service of Pharmacy, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - J P Horcajada
- Service of Infectious Diseases, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Grau
- Service of Pharmacy, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Affiliation(s)
- A Retamero
- Pharmacy Department, Hospital del Mar, Barcelona
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17
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Florit-Sureda M, Conde-Estévez D, Vidal J, Montagut C. Hypersensitivity reaction caused by folinic acid administration: a case report and literature review. J Chemother 2016; 28:500-505. [DOI: 10.1179/1973947815y.0000000048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Conde-Estévez D. Targeted cancer therapy: interactions with other medicines. Clin Transl Oncol 2016; 19:21-30. [DOI: 10.1007/s12094-016-1509-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/29/2016] [Indexed: 12/29/2022]
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Pérez-García A, Landecho MF, Beunza JJ, Conde-Estévez D, Horcajada JP, Grau S, Gea A, Mauleón E, Sorli L, Gómez J, Terradas R, Lucena JF, Alegre F, Huerta A, Del Pozo JL. Enterococcal bloodstream infection. Design and validation of a mortality prediction rule. Int J Clin Pract 2016; 70:147-55. [PMID: 26817569 DOI: 10.1111/ijcp.12754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection. METHODS A prediction rule was developed by analysing data collected from 122 patients diagnosed with enterococcal BSI admitted to the Clínica Universidad de Navarra (Pamplona, Spain); and validated by confirming its accuracy with the data of an external population (Hospital del Mar, Barcelona). RESULTS According to this model, independent significant predictors for the risk of death were being diabetic, have received appropriate treatment, severe prognosis of the underlying diseases, have renal failure, received solid organ transplant, malignancy, source of the bloodstream infection and be immunosuppressed. The prediction rule showed a very good calibration (Hosmer-Lemeshow statistic, P = 0.93) and discrimination for both training and testing sets (area under ROC curve = 0.84 and 0.83 respectively). CONCLUSIONS The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the threshold value, will have a low risk of death with a negative predictive value of 96%.
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Affiliation(s)
- A Pérez-García
- Department of Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - M F Landecho
- Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Clinica Universidad de Navarra, Pamplona, Spain
| | - J J Beunza
- Interdusciplinar Education, Universidad Europea, Pamplona, Spain
| | - D Conde-Estévez
- Service of Pharmacy, Hospital Universitari del Mar, Barcelona, Spain
| | - J P Horcajada
- Service of Infectious diseases, Hospital Universitari del Mar, Institut Hospital del Mar d'Investigacions Médiques, CEXS-Universitat Pompeu Fabra, CIBERES, Barcelona, Spain
| | - S Grau
- Service of Pharmacy, Hospital Universitari del Mar, Barcelona, Spain
| | - A Gea
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
| | - E Mauleón
- Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - L Sorli
- Service of Infectious diseases, Hospital Universitari del Mar, Institut Hospital del Mar d'Investigacions Médiques, CEXS-Universitat Pompeu Fabra, CIBERES, Barcelona, Spain
| | - J Gómez
- Depatament of Microbiology, Laboratori de Referencia de Catalunya, Barcelona, Spain
| | - R Terradas
- Service of Evaluation and Clinical Epidemiology, Hospital Universitari del Mar, Barcelona, Spain
| | - J F Lucena
- Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Clinica Universidad de Navarra, Pamplona, Spain
| | - F Alegre
- Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Clinica Universidad de Navarra, Pamplona, Spain
| | - A Huerta
- Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Clinica Universidad de Navarra, Pamplona, Spain
| | - J L Del Pozo
- Division of Infectious diseases, Department Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
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López Garcýa B, Ortonobes Roig S, Servitja S, Grau S, Tusquets I, Salas E, Albanell J, Conde-Estévez D. 1624 Antibiotic lock therapy with vancomycin and daptomycin for cathether salvage in long-term catheter. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30712-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Conde-Estévez D, Echeverría-Esnal D, Tusquets I, Albanell J. Potential clinical relevant drug-drug interactions: comparison between different compendia, do we have a validated method? Ann Oncol 2015; 26:1272. [PMID: 25791633 DOI: 10.1093/annonc/mdv151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- D Conde-Estévez
- Department of Pharmacy, Hospital del Mar.Barcelona; Hospital del Mar Medical Research Institute (IMIM), Barcelona.
| | | | - I Tusquets
- Hospital del Mar Medical Research Institute (IMIM), Barcelona; Department of Medical Oncology, Hospital del Mar.Barcelona; Medical Oncology Department, Universitat Autònoma de Barcelona, Barcelona
| | - J Albanell
- Hospital del Mar Medical Research Institute (IMIM), Barcelona; Department of Medical Oncology, Hospital del Mar.Barcelona; Medical Oncology Department, Pompeu Fabra University, Barcelona, Spain
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Urbina O, Ferrández O, Grau S, Luque S, Mojal S, Marin-Casino M, Mateu-de-Antonio J, Carmona A, Conde-Estévez D, Espona M, González E, Riu M, Salas E. Design of a score to identify hospitalized patients at risk of drug-related problems. Pharmacoepidemiol Drug Saf 2014; 23:923-32. [DOI: 10.1002/pds.3634] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/30/2014] [Accepted: 04/02/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Olatz Urbina
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | - Olivia Ferrández
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | - Santiago Grau
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
- Pharmacy Department; Hospital Universitari del Mar, Universitat Autònoma de Barcelona; Barcelona Spain
| | - Sonia Luque
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | - Sergi Mojal
- Department of Statistics; Hospital Universitari del Mar; Barcelona Spain
| | | | | | - Alexia Carmona
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | | | - Merce Espona
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | - Elena González
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
| | - Marta Riu
- Department of Epidemiology and Health Services Evaluation; Hospital Universitari del Mar; Barcelona Spain
| | - Esther Salas
- Pharmacy Department; Hospital Universitari del Mar; Barcelona Spain
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Arriola E, Conde-Estévez D. Onartuzumab. Anti-HGFR (c-Met) monoclonal antibody, oncolytic. DRUG FUTURE 2014. [DOI: 10.1358/dof.2014.039.06.2138674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barrantes-González M, Grau S, Conde-Estévez D, Salas E, Marín-Casino M. [Influence of ethnicity on the pharmacokinetics of amikacin]. Rev Esp Quimioter 2013; 26:346-352. [PMID: 24399348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Despite the increasing ethnic diversity, there are few studies of its influence on the pharmacokinetics of amikacin. The objective of this study was to compare the pharmacokinetics of amikacin in different populations: Asian, Hispanic, North Africans and Caucasian. METHODS A retrospective observational study was performed in a tertiary teaching hospital during eight years. It was included all patients with intravenous amikacin treatment in extended interval dosing regimen with therapeutic drug monitoring of amikacin. Pharmacokinetic parameters were analysed. A bivariate and multiple linear regression statistical analysis were carried out. RESULTS 164 patients were included: 7 asians, 135 Caucasians, 11 Hispanics and 11 from North Africa. It was shown a lower plasma concentrations of amikacin in North Africa population due to its greater clearance. CONCLUSIONS Amikacin plasma concentrations monitoring is advisable in patients from North Africa in order to avoid subtherapeutic concentrations.
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Affiliation(s)
- Melisa Barrantes-González
- Melisa Barrantes-González, Departamento de Farmacia. Hospital del Mar. Universidad Autónoma de Barcelona. Passeig Marítim 25-29, 08003, Barcelona, Spain.
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Abstract
Extravasation of cytotoxic agents is a true medical emergency. Dexrazoxane is the only licensed drug for the treatment of anthracycline extravasations. Dexrazoxane proved to be effective and moderately well tolerated. However, alternative approaches for the management of anthracycline extravasations are available such as topical DMSO and cooling. There appears to be general agreement about dexrazoxane usefulness when extravasations involve large volumes of anthracycline and/or central venous access device. Nevertheless, the non-invasive combination of DMSO and cooling is the most commonly described therapy, particularly in small anthracycline extravasations. Further research is still needed to establish unequivocal situations where dexrazoxane must be initiated.
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Affiliation(s)
- D Conde-Estévez
- Department of Pharmacy, Hospital Universitari del Mar. Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain,
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Conde-Estévez D, Mateu-de Antonio J. Comment on: management of chemotherapy extravasation: ESMO-EONS clinical practice guidelines. Ann Oncol 2013; 24:1128-9; author reply 1129-30. [PMID: 23393123 DOI: 10.1093/annonc/mdt021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Conde-Estévez D, Gómez-Ulloa D, Bundó AV, Antonio JMD, Florit M, Ferrándiz RB, Salas E, Albanell J. Oral anticancer agents: a prospective pilot study of a patient educational surgery run by a pharmacist and a nurse. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Conde-Estévez D, Grau S, Alvarez-Lerma F. Stenotrophomonas maltophilia y tigeciclina en la práctica clínica. Enferm Infecc Microbiol Clin 2012; 30:170-1. [DOI: 10.1016/j.eimc.2011.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 11/15/2011] [Indexed: 10/14/2022]
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Gómez-Ulloa D, Bundó AV, Antonio JMD, Arriola E, Conde-Estévez D. Cutaneous recall phenomenon with vinorelbine. Ann Pharmacother 2011; 45:1168-9. [PMID: 21862715 DOI: 10.1345/aph.1q279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Conde-Estévez D, Mateu-de Antonio J. [Update in the management of extravasations of cytocytostatic agent]. Farm Hosp 2011; 36:34-42. [PMID: 21798785 DOI: 10.1016/j.farma.2011.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 01/24/2011] [Accepted: 01/27/2011] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To present current developments in the specific management of extravasations of antineoplastic agents after the extravasation. METHOD We conducted a search in PubMed, Medline and IDIS-Iowa to identify papers written in English or Spanish that described new specific measures for the management of extravasations. We also reviewed the references given in these papers and recent tertiary sources related to oncology or cytostatic agents. The search covered the period between 1997 and 2010. RESULTS There are only specific measures for the treatment of extravasations of 22 cytostatic agents. These measures are presented for each cytostatic agent, according their drug group. CONCLUSIONS Although currently there is no general consensus on the specific management of antineoplastic agents after extravasation, this review outlines the information collected and published so far, so that it may be of use to any national health centre where cytostatic drugs are prescribed, handled or administered.
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Affiliation(s)
- D Conde-Estévez
- Servicio de Farmacia, Hospital del Mar (Parc de Salut Mar), Barcelona, España.
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Grau S, Conde-Estévez D, Luque S, Alvarez-Lerma F, Horcajada JP, Mateu-De Antonio J, Berenguer N, Salas E. Factors associated with adherence to guidelines for the use of tigecycline in a tertiary care hospital. J Chemother 2010; 22:339-44. [PMID: 21123158 DOI: 10.1179/joc.2010.22.5.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We assessed the adherence to the prescribing hospital protocol for tigecycline and factors associated with noncompliance. A total of 103 patients were included in the study. In 23 (22.3%) patients, tigecycline was not administered according to the protocol, mostly because of the availability of other therapeutic alternatives and prescription for indications that were not included in the guidelines. factors independently associated with nonadherence to the protocol were community-acquired infection (OR, 14.01; 95% CI, 1.54-127.12; P=0.019), and empirical tigecycline treatment (OR, 6.97; 95% CI, 0.88-55.40; P=0.066). penicillin allergy (OR, 0.004; 95% CI, 0.000-0.071; P=0.001) and previous antibiotic treatment (OR, 0.025; 95% CI, 0.003-0.233; P=0.001) were factors associated with adherence to the hospital protocol. A positive time trend between total number of prescriptions and non-compliant prescriptions with the protocol was observed (Spearman's rho coefficient 0.971; P=0.001). Adherence to tigecycline protocol could be improved by focusing on protocols for community-acquired infections, mainly skin and soft tissue infections.
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Affiliation(s)
- S Grau
- Hospital Universitari del Mar, Autonomous University of Barcelona, Spain.
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Alvarez-Lerma F, Blanco L, Rodríguez JA, Grau S, Conde-Estévez D, Luque S. [Differences in the use of tigecycline between ICU patients and non-ICU patients]. Rev Esp Quimioter 2010; 23:63-71. [PMID: 20559603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Tigecycline is a new broad spectrum antibiotic that is predominantly used for the treatment of severe infections both in critically ill patients admitted to the ICU and in non-ICU patients with less severe clinical conditions. OBJECTIVE To assess differences in the use of tigecycline between ICU patients and non-ICU patients treated with this antibiotics. MATERIALS AND METHODS Retrospective, cohort, observational study in which cases were defined as patients who received one or more doses of tigecycline over the first 18 months after approval of the drug in a general hospital. Clinical characteristics, indications, route of administration, clinical response, tolerability and outcome were recorded in the groups of ICU and non-ICU patients. Descriptive data and results of the comparison of both cohorts are presented. RESULTS A total of 103 were included in the study, 34(33%) of which received tigecycline during their stay in the ICU. ICU patients compared to non-ICU patients had a higher SAPS II score on admission (39.0 +/- 11.8 vs 26.3 +/- 8.0, p < 0.001) and at the time of starting tigecycline treatment (42.2 +/- 12.6 vs 25.6 +/- 8.2, p < 0.001), were treated with antibiotics for more days (21.4 +/- 30.6 vs 13.6 +/- 30.5 days, p < 0.012) and received a greater number of antibiotic agents concomitantly (85.3% vs 47.8%,p < 0.001), presented a higher selection of emerging bacterial flora (41.2% vs 15.9%, p =0.005), particularly Pseudomonas aeruginosa (20.6%vs 2.9%, p =0.006), higher rate of clinical failure (58.8%vs 21.7%, p < 0.001), longer hospitalization (51.2 +/- 39.4 vs 28.7 +/- 26.3 days, p < 0.001) and higher overall mortality rate (50% vs 14.5%, p < 0.001) and infection-attributed mortality (20.6% vs 7.2%, p =0.047). CONCLUSIONS The patient that receives tigecycline in the ICU has a higher severity level and worse clinical outcome than the non-ICU patient treated with this antibiotic. It is necessary to optimize the indications of tigecycline in the ICU to improve the clinical results.
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Affiliation(s)
- F Alvarez-Lerma
- Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, Spain.
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